Femoral Neck Stress Fracture vs Hip Flexor Strain

[Penny Abdiel]

Wondering if anyone has had either of these injuries. I had been running consistent 50ish mile weeks, training for the Philly marathon. Tapered for one week down to about 29 miles, then raced Philly RnR HM. During the taper week, I noted some hip flexor tightness (not unexpected, because I hadnt been consistently stretching/rolling and I sit at a desk for many long hours) and a little nagging groin pain, but nothing that affected my gait.

I raced very hard, and didnt feel any pain til I finished. Hip flexor/groin pain prevented me from doing a cool down. The days after the race, I could barely walk, and walking up/down stairs was really tough. When rolling out my quads, the muscles on that leg were absolutely on fire. Stretching out my hip flexor and IT band does bring some relief, at least in mobility.

Now, a week and a half later, i can walk almost without problem (a little limpy on that side). Climbing stairs is fine, but not perfect. I have no pain while sitting, lying down or in the morning.

The two tests I've performed to self diagnose are: 1) the hop test. I failed. It hurt in the front of the hip, quite deep (I can imagine the pain emanating from the femoral neck); and 2) lifting my knee to my chest hurts, consistent with a hip flexor strain (I have had this before).

Obviously I will not be running until I actually can, and can do so without pain. However the different diagnoses will affect how/whether I attempt to cross-train. With the muscle pain, i would put up with slight stiffness/discomfort and do elliptical or something, but with a stress fracture I'd limit it to pool running (ie no impact). While usually I'd head to my doctor asap, my insurance has changed and the new plan doesnt kick in for a few weeks.

Anyone experienced a FN stress fracture or hip flexor strain and can help?

[Riley Cook]

I have had two stress fractures in my femur. Usually with stress fractures you will often wake up in the middle of the night with pain in the area. I've noticed that I can run with stress fractures and it will hurt for the first 0.5 miles or so and then go away until I am done. At that point it becomes quite painful again. Pain relievers such as IB profin or Alieve don't help at all and neither does icing or compression. Pressing down on the bone in the area where it hurts will usually (but not always) yield a painful response.

Hopefully that helps...Also, the stress fractures I had never showed up on x-rays. I had to get bone scans both times to get the diagnosis. I was off 6-8 weeks with no running both times. I was able to cross train though: stationery bike and pool jogging. Taking a calcium supplement may help too with a quicker recovery.

I can't say for sure which injury you have, I'm certainly not a doctor. But, those are what symptoms I had. Hopefully that can help you with your self-diagnosis.

[Penny Abdiel]

Interesting - thanks Riley. No pain at night... though I have read that it is not uncommon for there to be no pain at rest with a hip stress fracture (versus a femoral shaft SFx).

There is absolutely no way I can run on this. I could barely manage a few steps when I last tried, and dont want to try again for fear of doing more damage.

Hopefully an MRI at my doctor's next week will be able to uncover what is going on. For now, I just want to proceed with the worst case scenario... so Im off to the pool tomorrow!

[Penny Abdiel]

Just to follow up (in case anyone has the same symptoms I did) MRI revealed that I had a stress reaction in my femoral neck. No muscle damage, and no labral tear. Thankfully I stopped running before it became a stress fracture. Time not running is about 7-8 weeks. No time on crutches (thank God) and could begin cross-training almost immediately. I can do anything that doesn't hurt.

Possible cause is diet and low bone density, for which Im upping dairy products and calcium/Vit D supplements.  Bone density test results coming next week.  It is apparently unlikely an overuse issue (or training mistake) because injury to this area of the femur is very rare (unlike, e.g., SFx in shins), so it is likely to do with having a structural weakness that needs to be corrected.

[Kam]

I wish you luck getting healed up and back into full training mode.  I'm glad you had sense to stop, and not keep running to a failure point.  I can't imagine a cracked femur.